How much rates vary
Facilitymedian $302 · 10th to 90th $209 to $6,026Professionalmedian $282 · 10th to 90th $186 to $427
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $229.09 | Professional | None | $173.78 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,000.00 | $1,737.80 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $407.38 | Professional | None | $204.17 | $245.47 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $354.81 | Professional | None | $223.87 | $281.84 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $6,025.60 Typical High $8,709.64 | Facility | None | $257.04 | $6,025.60 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $446.68 | Professional | None | $223.87 | $229.09 | $446.68 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $295.12 Typical High $302.00 | Facility | None | $177.83 | $295.12 | $302.00 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $1,659.59 Typical High $2,454.71 | Facility | None | $371.54 | $1,659.59 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $436.52 | Professional | None | $79.43 | $288.40 | $436.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $9,332.54 Typical High $14,125.38 | Facility | None | $6,165.95 | $9,332.54 | $14,125.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $407.38 | Professional | None | $288.40 | $302.00 | $407.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $467.74 | Professional | None | $223.87 | $281.84 | $467.74 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $134.90 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $104.71 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $41.69 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $154.88 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.89 | $22.91 | $22.91 |
Where Oregon sits
The same service costs 11.1 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $5,221MT $469
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.